Measuring health-related quality of life of patients with metastatic colorectal cancer using the Jordanian EQ-5D-3L value set: a cross-sectional observational study.

OBJECTIVE: Health-related quality of life (HRQoL) of metastatic colorectal cancer (mCRC) in Jordan has been previously evaluated using disease-specific HRQoL tools. Meanwhile, data on HRQoL utility scores for calculating Quality-Adjusted Life Years for economic evaluations are lacking. In this study, we aim to describe, measure and identify predictors of HRQoL utility scores in patients with mCRC. DESIGN: This was a cross-sectional, non-interventional, observational study. SETTING: A specialised cancer centre in Jordan. PARTICIPANTS: A cross-sectional questionnaire survey was conducted on 164 mCRC adult patients. OUTCOME MEASURES: Using the five-level EuroQol-3-dimension (EQ-5D-3L) instrument, patients' health profiles were described and then valued using the EQ-5D-3L value set for Jordan to generate a single utility score. The Kruskal-Wallis test assessed differences in mean utility scores across patient characteristic categories. A Tobit regression model was used to identify potential predictors of HRQoL in mCRC patients. RESULTS: A total of 164 patients were enrolled with a mean age of 59 years, a mean utility score of 0.78 (SD±0.25) and visual analogue scale score of 68.78 (SD: ±19.9). 19% of patients had a stoma, and most of the patients reported health problems (72%); pain and discomfort were reported by (55%), followed by mobility (32%), usual activities (29%), anxiety/depression and self-care (13%). Analysis revealed that patients with more than one metastatic site, those who received more than one line of systemic treatment, were currently on chemotherapy, received systemic therapy in the last year or had peritoneal metastasis were found to have significantly lower utility scores (p<0.05). In contrast, patients who were employed at the time of the interview had significantly higher utility scores (p<0.05). A multivariate Tobit regression model showed that the number of metastatic sites and number of systemic treatment lines were significant predictors of lower utility scores (p<0.05). Conversely, being employed was a significant predictor of higher utility scores (p<0.05). CONCLUSION: Utility scores measured in this study could be valuable for future economic evaluations of mCRC treatments. Pain and discomfort were the most reported problems among patients, highlighting the need for further evaluation to improve pain management strategies. Additionally, our regression analysis identified significant predictors of HRQoL.